Crtical pathway analysis of variance in child pneumonia

Drafting a block critical pathway adopting STEP

Abstract

It has been considered difficult to adopt pathway analysis for acute child diseases because of high variances due to differences in symptoms' improvement between individuals. The Isesaki Citizens Hospital utilizes critical pathway in child pneumonia with fixed outcome since2004, but variances have occurred in all cases. Thus, we conducted a variance analysis to pursue causes, and to draw up ablock critical pathway (hereafter BCP) adopting STEP. STEP consisted of 3 steps, with the criteria of each step-up definitely set on the results of variance analysis: step 1, no fever and no difficulty in respiration; step 2, improvement of total body conditions and test data; step 3, no exacerbation after treatment with antimicrobial drugs. We defined variances to have occurred when a step-up was not achieved within days of the setting.
The introduction of BCP adopting STEP made it possible to restrain the occurrence of variances, and we found that the step-up BCP is useful in acute diseases.